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Review article: Non-alcoholic fatty liver disease
1Division of Gastroenterology and Hepatology, Mayo Clinic Foundation, Rochester, MN, USA.
Alimentary Pharmacology & Therapeutics
|April 16, 2003
Summary
Non-alcoholic fatty liver disease (NAFLD) encompasses a range of liver damage. Early diagnosis and management of associated conditions are crucial for preventing progression to advanced liver disease.
Area of Science:
- Hepatology
- Gastroenterology
- Internal Medicine
Background:
- Non-alcoholic fatty liver disease (NAFLD) is a spectrum of liver conditions, from simple steatosis to cirrhosis.
- Non-alcoholic steatohepatitis (NASH) is a stage characterized by steatosis and necro-inflammation.
- NAFLD affects an estimated 10-24% of the global population, with its full prevalence unknown.
Purpose of the Study:
- To define the clinicopathological spectrum of NAFLD.
- To outline diagnostic criteria for NAFLD.
- To describe the natural history and management strategies for NAFLD.
Main Methods:
- Diagnosis relies on excluding alcohol use, histological liver biopsy findings, and ruling out other liver diseases.
- Patient outcomes are stratified based on histological findings (steatosis, necro-inflammation, fibrosis).
- Treatment focuses on managing comorbidities like obesity, diabetes, and hyperlipidemia.
Main Results:
- Pure steatosis follows a generally benign course.
- Necro-inflammatory changes and fibrosis indicate potential progression to end-stage liver disease.
- Investigational therapies may benefit patients with NASH and/or fibrosis.
Conclusions:
- NAFLD management requires addressing associated metabolic conditions.
- Liver biopsy is essential for staging NAFLD and guiding treatment.
- Liver transplantation is an option for patients with decompensated cirrhosis due to NAFLD.